Winter blues in elderly men: The problems of prostate
Prof Dr Liaqat Ali
Prostate is a male genital gland that is located beneath the urinary bladder and rests on pelvic floor muscles. Through this, it traverses the urethra that is called prostatic urethra. The normal size of the prostate is 20 gm. After the age of 40, prostate gland starts increasing, usually in benign manners, and the median age of presentation is 52 years.
The enlargement of prostate presents as difficulty in micturition like awakening more than one time from sleep in the night, desire to urinate within two hours during the day, irresistible desire to urinate (urgency), time lag in starting urination (hesitancy), poor urinary stream, straining, and sense of incomplete emptiness.
Despite these common symptoms, unfortunately in Pakistan, prostate presents as a complication when a senior citizen is not able to urinate in 67 percent of the cases. There are countless number of treatment modalities for enlarged prostate, with one objective and that is: “To improve the quality of life”, as also said by Aristotle that the quality of life is more important than life itself.
Though the shades of autumn and winters have no direct effect on prostate, however, the winter blues increase the clinical presentations of prostate and can transform stable prostate patient to unstable prostate due to the aforementioned reason, whereas the increased consumption of hot beverages like tea and coffee during long winter nights tends to diuresis the patient with more need for urination.
Similarly, senior citizens intentionally withhold urine during chilly weather for prayers or travels. The chilled water used for ablution causes spasms of pelvic floor muscles, resulting in more narrowing of urethra.
The common cold and flu are also more prevalent in dry winters. The common medications against cold and flu negatively affect the neurophysiology of urinary bladder and aggravates the symptoms of prostate. Sudden exposure to chilly winter breeze even results in spasm of pelvic floor muscles.
The easy remedies to prevent severity of urinary symptoms during beautiful winters in ageing men are very simple and only need behavioral and lifestyle modifications. These simple lifestyle modifications can prevent serious complications and the need for surgery in this regard.
As prevention is better than cure, so do not stop the prostate medications prescribed by your family physician or urologist, keep yourself warm and covered while moving outside home in winter, avoid excessive water intake, green tea, juices, and tea etc. after evening and at night, use warm water for ablution before prayers, avoid withholding urination unnecessarily during traveling, family functions, and friends’ reunions, inform your family physician in common cold and flu that you are on the treatment for prostate, consult a qualified urologist as soon as possible if symptoms worsen, and do not consider the clinical features of prostate as mere ageing phenomena, because, early initiation of medical treatment improves the quality of life and decreases the need for surgery.
The writer is working at the Department of Urology, Institute of Kidney Disease (IKD), Hayatabad Medical Complex (MTI-HMC), Peshawar. He has been managing all the complex renal stones since 2007. His involvement in patient care, surgical treatment, community awareness campaign, and innovative research in the field of urology has gotten national and international acclaim. The Department of Urology, IKD in liaison with NUST Islamabad, has also started innovative research on Nanotechnology and the study of elementome in renal stone diseases under his leadership.
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